Sacrum/Coccyx and SI Jnts.

1. Sacrum/Coccyx and SI Jnts.

2. Routine Views: • Sacrum/Coccyx • AP axial • Lateral

3. AP Axial Sacrum

4. Structures Shown • The entire sacrum free of superimposition

5. Good film: • The pubic bones should not overlap the sacrum • No foreshortening (angle 15 degrees up) • Good even contrast • No rotation • Sacrum centered to film • Good collimation • Fecal material should not overlap the sacrum

6. AP Axial coccyx

7. Here is a list of some of physical traumas that tailbone sufferers have experienced and reported from Tailbone.com: Auto Accident, rear-end collisionAuto Accident, vertical fall from a cliffChild birth (vaginal) deliveryDead-lifting of heavy weights or barbellsFall on the buttocks down the stairs or laddersFall on the buttocks during Cheerleading Stunts (Throw & catch or Pyramids) Fall on the buttocks during gymnastics on a balance beam Fall on the buttocks during ice skatingFall on the buttocks during roller blading or in-line skatingFall on the buttocks during roller skatingFall on the buttocks during skiingFall on the buttocks during snow boardingFall on the buttocks from a swingFall on the buttocks in a bath tubFall on the buttocks in a bathroomFall on the buttocks on a frozen sidewalkFall on the buttocks on a oily or greased floorFall on the buttocks while skate boardingHorseback riding or falling from a horseMartial Art accidental contact with buttocksProlonged sittingSexual intercourseSitting during PregnancySitting on a bicycle seat with gel paddingSitting on a broken car seat or office chairSitting on a thinly padded bicycle seatSitting on hard surfaces such as stadium bleachersSlip and fall on a hard slippery/wet tile floorSports injury, accidental kick in the buttocksStraddle injury on a fence top or tree limbWater slide drops and jumps

8. Structures Shown • The whole coccyx and distal sacrum free of superimposition

9. Good Film • The coccygeal segments should not be superimposed by pubic bones (angle) • Good even contrast • Coccyx should be centered to film and seen in its entirety • No rotation • Good collimation • Do they need to use the restroom?

10. Lat. Sacrum/coccyx

11. Structures Shown • The lateral aspect of the entire sacrum and entire coccyx (**for L-S spine it is okay to clip coccyx)

12. Good Film: • The sacrum and coccyx should be seen clearly with even contrast • Good collimation • Superimposed iliac crest

13. SI joints • AP Axial ( same as up shot on L-S spine) • RPO/LPO

14. AP Axial SI joints Same as AP axial for L-S spine Junction

15. RPO/LPO SI joints R L LPO RPO

16. Structures shown: • Shows the sacroiliac joint farthest from the IR and an oblique projection of the adjacent structures **Always do both obliques for comparison

17. Good Film: • Open SI joint space with minimal overlapping of the ilium and sacrum • Joint centered on the film